Presentation
Left flank pain and hematuria.
Patient Data
A 95×75 mm hetero enhancing mass is noted at the left kidney that infiltrates the collecting system and extends into the proximal half of the left renal vein. Perirenal fat stranding and enlarged para aortic lymph node with SAD of 10 mm are also observed.
In imaged portions of the lower thorax, severe cardiomegaly is present, causing adjacent lung collapse.
Case Discussion
Large left renal mass with regional enlarged lymph node and vascular extension.
The patient underwent left radical nephrectomy, and histopathology evaluation confirmed renal cell carcinoma.
Renal cell carcinoma staging using the TNM staging system and when tumor grossly extends into the renal vein or its segmental branches, or tumor invades perirenal and/or renal sinus fat but not beyond the Gerota fascia, compatible with T3a.